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277 Development of a patient decision aid for invasive diagnostic testing in ischemic patients with non- obstructive coronary artery disease
  1. Dinah LVan Schalkwijk1,
  2. Anouk EC Bruijnzeels1,
  3. Jos WMG Widdershoven1,2,
  4. Paula MC Mommersteeg1
  1. 1Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, Netherlands
  2. 2Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg, Netherlands


Introduction Ischemia with non-obstructive coronary arteries (INOCA) is a chronic heart condition predominantly affecting women and characterized by a reduced quality of life. Diagnostic testing for INOCA is invasive, unpleasant, and carries inherent risks. Previous research underscores the necessity for a Patient Decision Aid (PtDA), as patients perceive the decision for diagnostic testing as crucial and complex.1 We aim to develop a PtDA to enhance the decision-making process for diagnostic testing in INOCA patients.

Methods Following the International Patient Decision Aids Standards, we developed a PtDA. First, focus groups and interviews were conducted with 22 patients and 12 healthcare professionals to assess their needs. Secondly, the requirements and format were defined. Third, using an iterative process and co- creation with patients, healthcare professionals, and design firms, two prototypes were developed.

The PtDA’s acceptability was tested with patients, and a multisite pilot study is planned to assess its effectiveness.

Results The ‘Coronary Function Testing Decision Aid’ is a handout featuring information on diagnostic and treatment options. Both are included to accommodate the possibility of starting treatment based on a working diagnosis without the necessity of an invasive diagnostic test. The handout covers the purpose, procedure, risks, and benefits of invasive diagnostic testing and other options. It also includes frequently asked questions and is adaptable for both online and print use. Patients have found the PtDA acceptable, and ongoing effectiveness testing is in progress with preliminary results forthcoming.

Discussion The acceptability testing showed the importance and need for a PtDA. By involving patients and healthcare professionals we ensured that the PtDA addresses the needs and preferences of individuals facing the decision about invasive diagnostic testing.

Conclusion(s) The developed PtDA serves as a valuable tool for patients with INOCA, facilitating informed decision- making regarding invasive diagnostic testing. The effectiveness is still being examined.


  1. van Schalkwijk DL, Widdershoven JWMG, Elias-Smale S, Hartzema-Meijer M, den Oudsten BL, Slatman J, Mommersteeg PMC. ShareHeart: A patient journey map of patients with ischemia and non-obstructive coronary artery disease based on qualitative research. JClinNursing. 2022;32(13–14):3434–3444.

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